Q. My wife is currently undergoing implant treatment to replace her upper 4 front teeth. This started out because one of her root fillings cracked and our regular dentist felt that he couldn’t coninue to reset the crown indefinately. On the recomendation of our dentist she saw a local cosmetic dentist who recommended replacing all 4 crowns with 2 implants and a bridge, despite reservations about the amount of expected gum/bone resession which the dentist assured us should not, in his opinion be excessive. As the gum resessed more than he expected, my wife undertook cow-bone relacement therapy prior to the implants being placed. At this stage she was also shown a wax-up of the proposed crown&bridge work which she rejected as they did not resemble her original crowns, or the temporary denture (which is an acceptable appearance) she had been given, as the ‘teeth’ were visibly & significantly smaller. At her last appointment she was presented with what to all intents and puposes should be the ‘Finished Article’. However, not only are the ‘teeth’ significantly longer than those of her denture with very little gumline, there is also a significant backward incline which would give the appearance of her having ‘buck-teeth’. On top of this there is a significant gap between the proposed bridge and her gum which results in a significant lisp when she talks. As she is a praticing Occupational Therapist who spends most of her time talking to clients and other profesionals this is unacceptable. Should we be insisisting on having the work redone to a standard we are happy with or do we just have to accept or reject it as beeng the best on offer. my wife feels particularly pressured as the dentist is wanting to permanently place the offered implants at her next appointment which is in two weeks time. Your advice on this would be much appreciated.

A. I would speak to him before the next appointment so that they can change these provisional teeth to something more acceptable to your wife before the final ones are made. There are always some compromises to be made in these cases but it doesn’t sound like she should accept something so different than what she really wants. It would be good to tell the dentist that the denture is quite close to what she wants for the fianl teeth.

Dr Andrew Moore
Advance Dental Clinic
Clinical Director
www.advancedentalclinic.com
Tel: 01245 268 494
104 Moulsham Street
Chelmsford Essex
CM2 0JG